[Risk assessment and risk prevention in infectious diseases]

The purpose of risk assessment is to provide source data to state and local health agencies and other administrative departments to aid in the development of approaches for risk management and preventive strategies. In respect of the far reaching consequences it is necessary to have evaluated and accepted measures for the risk assessment. The system of risk assessment was developed in the USA for the assessment of chemical substances and includes the identification of the hazard, the exposure assessment, the dose-response-assessment and the risk assessment. Basis for the risk assessment are detailed information of the chemical substance or the pathogen and epidemiologic data. Preventive strategies and risk management like the stop of production have great social and economic consequences. Risk management must be highly effective. In a historic review it is described that in the past of the former centuries infectious diseases were tried to prevent or control in a wrong manner in consequence of the lack of knowledge about the etiology of infectious diseases. Since Robert Koch there was the beginning of an effective risk assessment and management of infectious diseases. Long time in this century it was thought that infectious diseases wouldn't play any role for the public health. Now it is clear that infectious diseases remain the leading cause of death and disability in the developed and underdeveloped countries and that the risk potential is increasing. Therefore risk-assessment and risk-management developed formerly for chemical substances are necessary for infectious diseases. Specific criteria for-the risk assessment for infectious diseases which are different to chemical substances are discussed like illness related, pathogen related, host related, transmission related factors and general aspects. The most important measures for risk management are discussed.